Improving patients' attention after a stroke could help them recover their motor skills

Scientists in New Zealand say after a stroke improving patients' attention could help them to recover their motor skills.

The team from the University of Auckland say impaired attention can reduce cognitive productivity and being able to focus on tasks is a key to re-learning motor skills and could aid recovery.

The researchers say impaired attention after stroke is the most prominent stroke-related neuropsychological change and they suggest it may be possible to improve this.

According to Dr Suzanne L. Barker-Collo, a senior lecturer and neuropsychologist at the University, impaired attention is reported in at least 46% and as many as 92% of stroke survivors.

The research team conducted a clinical trial using Attention Process Training (APT) with 78 stroke survivors who were randomly assigned to receive APT or standard rehabilitation care - APT is designed to improve the ability to maintain attention, as well as to shift attention (such as when having a conversation with more than one person) and to attend to more than one thing at a time and has been used successfully in people after traumatic brain injuries.

In the first ever test to be carried out with stroke patients four aspects of attention were tested - sustained, selective, divided and alternating - as well as visual and auditory aspects of attention.

Patients receiving APT had up to 30 hours of individual training, in one-hour sessions for four weeks and received on average 14 hours of training.

The researchers say people who underwent APT had a significantly greater improvement on a test of attention than those who received standard care - at six months, those who had APT had an average improvement of 2.49 standard deviations higher than standard care patients on "full-scale attention scores."

As the improvement in attention did not correlate with significant improvements in outcomes, the researchers suggest that six months may not be enough time to gauge the impact of improved attention and say more research is needed on the issue and early identification and rehabilitation of attention should be part of stroke rehabilitation because APT is a viable and effective way to improve attention deficits after stroke.

The research is published in Stroke: Journal of the American Heart Association.